New study suggests promising drug combinations for sleeping sickness

Results from a clinical trial evaluating new drug combinations for
sleeping sickness, carried out by the international humanitarian
medical aid agency Medecins Sans Frontieres (MSF), and its research
arm, Epicentre, have now been published in the journal PLoS Clinical
Trials.

African trypanosomiasis, or sleeping sickness affects many tens of
thousands of people each year in sub-Saharan Africa and is a serious
disease for which there are few treatment options. The most commonly
used drug, Melarsoprol, is highly toxic. MSF and Epicentre jointly
carried out a trial that started in 2001 in Uganda to evaluate the efficacy and
safety of three drug combinations for this disease. The aim was to
find out if any of these combinations would provide a viable treatment
option for patients with second-stage sleeping sickness, where
infection has reached the brain and prognosis is normally very poor.
In the trial the drug combinations compared were
melarsoprol-nifurtimox, melarsoprol-eflornithine, and
nifurtimox-eflornithine. However, once 54 patients had been recruited
(435 were planned), it was obvious that the death rate was much higher
amongst individuals receiving one of the combinations, so the trial
was stopped.

In the trial, the cure rate for nifurtimox-eflornithine was over twice
that for melarsoprol-nifurtimox and substantially higher than that for
melarsoprol-eflornithine. The rates of adverse events were also lower
for patients treated with nifurtimox-eflornithine. These findings are
encouraging and suggest that the nifurtimox-eflornithine combination
has potential as a future therapy for second-stage African
trypanosomiasis, and should be evaluated further in clinical trials.

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Last reviewed:
By John M. Grohol, Psy.D. on
30 Apr 2016
Published on PsychCentral.com. All rights reserved.